Just got done with my phenol cross procedure. Took about 10 minutes. The nurse took some photos of my scars with top/down lighting. They prepared the area by applying alcohol via swab to my cheeks and temples to cleanse the area of any oil and dirt. Phenol was applied individually to my icepicks and boxcar scars. There was a stinging sensation which lasted about 40 minutes. Haven't noticed any "frosting" effect of the scars so far.
For aftercare protocol I was told to avoid sun exposure. At night I can use a gentle facial cleanser, moisturizer, lightly splash water on my face, as well as apply aloe vera or vaseline to the areas.
Do I want to keep the scars moist or should I let them form scabs? Any others things I could be doing in the meantime to aid in the healing process?
Bumping this thread again. It's been some time since my last treatments. Was content with my scars for a bit after healing from my phenol cross with Dr. Rullan. Suddenly, I have been more attentive towards my scars again, constantly taking selfies and looking into mirrors. Feeling defeated and discouraged. Almost thinking I made very little progress from the treatments I have received. Getting desperate at this point, was hoping to get this resolved since I started this journey years ago. Feel like life is passing me by.
Looking for advice on where to go with my treatments.
On 4/13/2022 at 2:41 AM, xander_33 said:Bumping this thread again. It's been some time since my last treatments. Was content with my scars for a bit after healing from my phenol cross with Dr. Rullan. Suddenly, I have been more attentive towards my scars again, constantly taking selfies and looking into mirrors. Feeling defeated and discouraged. Almost thinking I made very little progress from the treatments I have received. Getting desperate at this point, was hoping to get this resolved since I started this journey years ago. Feel like life is passing me by.
Looking for advice on where to go with my treatments.
From your first post of your photos to the photos you posted now, the improvement is very noticeable. Sure, you still have little bit of scarring but from where you started, you have come a long way. I am going through the same feelings as you, so I will try to remind you to enjoy your life as best you can. I try to tell myself that. I feel guilty when I obsess about my scarring when i™m in the middle of a family event or special event, it takes me out of the present. I try to remind myself that if my scars are to show and people notice them, they will slowly fade into the back of their minds because the human brain doesn™t focus on it for too long. Have you ever seen someone with someone at first that was noticeable but as time went on, you forgot it was there? I imagine this is how people are when they look at me. I™m sure they take a mental note and then the brain switches to œwell, let™s see the rest of this specimen and make a judgment and you know what? I™ve got a lot of other things that take the attention off of my insecurities. Idk, I™m just trying to help you frame your mind. But there is also more improvement you can achieve with your scar journey. Take a break and breathe. You have tunnel vision.
Final note, I wouldn™t note your scars much if I saw you from this lighting. And this is your worst lighting, right? I can barely note them. I™m not saying your concerns or feelings are irrelevant, I™m simply saying that to a normal person, I™d highly doubt anyone picks up on your skin texture for too long. As the saying goes, we are our own worst critics.
On 4/15/2022 at 9:32 PM, Dontgiveupitsonlyscars said:From your first post of your photos to the photos you posted now, the improvement is very noticeable. Sure, you still have little bit of scarring but from where you started, you have come a long way. I am going through the same feelings as you, so I will try to remind you to enjoyyour life as best you can. I try to tell myself that. I feel guilty when I obsess about my scarring when im in the middle of a family event or special event, it takes me out of the present. I try to remind myself that if my scars are to show and people notice them, they will slowly fade into the back of their minds because the human brain doesnt focus on it for too long. Have you ever seen someone with someone at first that was noticeable but as time went on, you forgot it was there? I imagine this is how people are when they look at me. Im sure they take a mental note and then the brain switches to well, lets see the rest of this specimen and make a judgment and you know what? Ive got a lot of other things that take the attention off ofmy insecurities. Idk, Im just trying to help you frame your mind. But there is also more improvement you can achieve with your scar journey. Take a break and breathe. You have tunnel vision.
Final note, I wouldntnote your scars much if I saw you from this lighting. And this is your worst lighting, right? I can barely note them. Im not saying your concerns or feelings are irrelevant, Im simply saying that to a normal person,Idhighly doubt anyone picks up on your skin texture for too long. As thesaying goes, we are our own worst critics.
I appreciate the advice. I remember your comments from last year and I also have been following your scar journey quite closely, since our scarring was similar. I am glad you touched on the feelingand sort of mental state many of us are in when it comes to our scars, which is thisnotionof feeling "present" in social situations. I find it difficult to interact with people as I am worried about how my scars will be perceived and this is what led to my most recent meltdown. Throughout the years I have fearedforming bonds and relationships because of the judgement I might receive. I feel like my scars are disfiguring as it affects my confidence greatly and sort of has been the catalyst for my depression and anxiety throughoutlife. While acne scarring has caused so much such trauma and anguishfor me, it has also been a humbling experience and has helped me discover and understand other important aspects to life. To your point about scars just being a minor part to the sort of holistic representation of a person, I agree with you entirely as thishas given me hope over the years. There are other features and aspects of my appearance that I am comfortable and confident with. I try to take care of myself and improve on my self through other means. with that being said, its your FACE, your identity, its such an intimate part to the individual.
Admittedly I was feeling a bit resentful when I made my previous post, because I have in fact noticed some improvement over the few treatments I have received, albeit not as much as I hoped for. I grown somewhat accustomed to how my skin looked in normal lighting conditions, tolerable really.It's the unfavorable lighting conditions,overhead lighting, that trigger these times of panic for me.
As far as acne scar treatment is concerned, I feel absolutely lost. I plan to maybe do 1 more subcision just to ensure that the scars are all untethered. A few more phenol/TCA crosses. I feel like my scars are very complex in their morphology. They're deep enough where modalities like laser might not be effective but they're also shallow to the point that excision might be too risky. I am worried lasers might do more harm (not afraid of hyperpigmentation, I would trade some hyperpigmentation for a reasonable level of scar improvement in a heartbeat). Laser results seem to be so mixed with some reporting good results whereas other reporting little to no effect on their scars. I was recommended things like multiple Fraxel and RF needling sessions but the sentimenton this discussion board regardingthese treatments is not that good.
On 4/17/2022 at 3:01 AM, xander_33 said:I appreciate the advice. I remember your comments from last year and I also have been following your scar journey quite closely, since our scarring was similar. I am glad you touched on the feelingand sort of mental state many of us are in when it comes to our scars, which is thisnotionof feeling "present" in social situations. I find it difficult to interact with people as I am worried about how my scars will be perceived and this is what led to my most recent meltdown. Throughout the years I have fearedforming bonds and relationships because of the judgement I might receive. I feel like my scars are disfiguring as it affects my confidence greatly and sort of has been the catalyst for my depression and anxiety throughoutlife. While acne scarring has caused so much such trauma and anguishfor me, it has also been a humbling experience and has helped me discover and understand other important aspects to life. To your point about scars just being a minor part to the sort of holistic representation of a person, I agree with you entirely as thishas given me hope over the years. There are other features and aspects of my appearance that I am comfortable and confident with. I try to take care of myself and improve on my self through other means. with that being said, its your FACE, your identity, its such an intimate part to the individual.
Admittedly I was feeling a bit resentful when I made my previous post, because I have in fact noticed some improvement over the few treatments I have received, albeit not as much as I hoped for. I grown somewhat accustomed to how my skin looked in normal lighting conditions, tolerable really.It's the unfavorable lighting conditions,overhead lighting, that trigger these times of panic for me.
As far as acne scar treatment is concerned, I feel absolutely lost. I plan to maybe do 1 more subcision just to ensure that the scars are all untethered. A few more phenol/TCA crosses. I feel like my scars are very complex in their morphology. They're deep enough where modalities like laser might not be effective but they're also shallow to the point that excision might be too risky. I am worried lasers might do more harm (not afraid of hyperpigmentation, I would trade some hyperpigmentation for a reasonable level of scar improvement in a heartbeat). Laser results seem to be so mixed with some reporting good results whereas other reporting little to no effect on their scars. I was recommended things like multiple Fraxel and RF needling sessions but the sentimenton this discussion board regardingthese treatments is not that good.
"I find it difficult to interact with people as I am worried about how my scars" Likewise... I still wear my mask or purposely hide from certain lighting because I know how my scars may look and it bothers me to my core if my scars for one minute take away from who I am. Perhaps that is my ultimately fear, that my scars will be the only thing people ever see when they look at me and the rest of myself becomes muted. But it is far from that. Sometimes the fear of something happening can take away more of your life than just living in your own self. I am slowly starting to realize this.
I think of it like the stages of grief: (1) denial, (2) blaming yourself, (3) anger/action to change reality, (4) depression (meltdowns, self-isolation, sleeping to avoid feelings, not opening my selfie camera, not taking pictures or selfies, washing my face in darkness, not attending events, etc), (5) self-reflection, (6) epiphany/realization that its going to be okay, and finally (7) acceptance. I'm definitely in the depression stage as I've detailed it there what my thoughts consist of. But other parts of me realize that we all have insecurities or things we want to hide, mine just happen to be my scars on my face. I've even contemplated the purpose of life and what i want out of it and if im still able to perform it even if every single person sees my scars, and there answer is yes, and yes, life is bigger than your face. Especially as we age, aging is a funny thing. It's humbling to every single person. Aging is a reminder that life is short and beauty/youth is temporary. But without aging, we do not live. In order to live, you need to surrender all your chains, even if they are self-made. This is not easily done, I'm still on my own journey to full acceptance of my scars after I've done everything reasonably possible to improve them. But there comes a point where enough is enough, the end of the line... it's all just superifical in the end. I hope to one day say: "So you'll judge me on my scars? So be it." To shrug so easily and not have a care in the world. I'm hoping more and more for those days than the days where my scars are "less noticeable". Because that's what this thing has done to me, put my own happiness in a prison. I'm not saying I'll ever give up on improvement, but there comes a point where I've done enough and it's not my fault, and my scars aren't everything. You know?
As for what may be next, I am also lost. I'm constantly researching when I have time off my studies to see whats next.
3 hours ago, Dontgiveupitsonlyscars said:"I find it difficult to interact with people as I am worried about how my scars" Likewise... I still wear my mask or purposely hide from certain lighting because I know how my scars may look and it bothers me to my core if my scars for one minute take away from who I am. Perhaps that is my ultimately fear, that my scars will be the only thing people ever see when they look at me and the rest of myself becomes muted. But it is far from that. Sometimes the fear of something happening can take away more of your life than just living in your own self. I am slowly starting to realize this.
I think of it like the stages of grief: (1) denial, (2) blaming yourself, (3) anger/action to change reality, (4) depression (meltdowns, self-isolation, sleeping to avoid feelings, not opening my selfie camera, not taking pictures or selfies, washing my face in darkness, not attending events, etc), (5) self-reflection, (6) epiphany/realization that its going to be okay, and finally (7) acceptance. I'm definitely in the depression stage as I've detailed it there what my thoughts consist of. But other parts of me realize that we all have insecurities or things we want to hide, mine just happen to be my scars on my face. I've even contemplated the purpose of life and what i want out of it and if im still able to perform it even if every single person sees my scars, and there answer is yes, and yes, life is bigger than your face. Especially as we age, aging is a funny thing. It's humbling to every single person. Aging is a reminder that life is short and beauty/youth is temporary. But without aging, we do not live. In order to live, you need to surrender all your chains, even if they are self-made. This is not easily done, I'm still on my own journey to full acceptance of my scars after I've done everything reasonably possible to improve them. But there comes a point where enough is enough, the end of the line... it's all just superifical in the end. I hope to one day say: "So you'll judge me on my scars? So be it." To shrug so easily and not have a care in the world. I'm hoping more and more for those days than the days where my scars are "less noticeable". Because that's what this thing has done to me, put my own happiness in a prison. I'm not saying I'll ever give up on improvement, but there comes a point where I've done enough and it's not my fault, and my scars aren't everything. You know?
As for what may be next, I am also lost. I'm constantly researching when I have time off my studies to see whats next.
I do relate In the same way although the scars are improved but it is really hard to forgive ourselves due to our genetic code of being predisposed to acne scars. I just wish I had the knowledge when i first started getting scars. Or maybe turn back time told myself go on retin a immediately. Or get those blackhead extracted asap. But then I think that so does every person who goes through accident would wish the same. Had he known but I still not understand this world. If acne is such a common condition and have such devastating effects on a persons mind then shouldnt this be taught to parents as what they need to lookout for and guide the children. I just feel like sometimes acne scars have stolen time of my life. Always feeling not myself in a room thinking about scars.
There is great progress in lifting your scars from the subcision imo. But your face will never be scar free.
We may need some superficial procedure like ablative laser surfacing, dermabrasion or phenol chemabrasion. This will soften the edges of the surface scars and make it look more normal.
I'd definitely recommend fillers or cupping after subcision to help lift the pitted scars.
Also for the phenol peel, it's better to not scab. Keep the wound moist, moisturizer + aquaphor/vaseline on top for 5 days or so. A moist wound speeds up healing and is standard procedure for a lot of lasers. Wash gently with a washcloth.
After procedures, use tretrinoin (prescription Vitamin A) and moisturizer with hyaluronic acid for at least a month, this makes your skin look as good as possible.
On emotional things: your scars do not define you. Sometimes I feel very self-conscious, as if everything I am reduces to my scars. However, I have other hobbies and things that give me great confidence. In the gym I feel skilled and confident. Use those things to your advantage. Also you notice your scars a lot more than other people. If you focus on them and let it define you, you lose out on the rest of the world.
I have another phenol cross procedure scheduled next month. During that visit I plan to discuss with Dr. Rullan what would be the best course of action for my scars.
Many of my scars have softened and I feel I just have bad overall texture. There are a few pits and atrophic areas that I want to try subcising once more. I want to ensure everything is leveled before deciding to go with laser resurfacing or dermabrasion.
I am in a tough spot right now. Whether or not to seek a strong ablative procedure or dermabrasion. Because of my ethnic skin doctors have cautioned me against CO2 lasers due to hyperpigmentation issues. I am getting exhausted at this point and might just take the risk.
I went to a plastic surgery clinic today and consulted with their aesthetician who evaluated my skin and afterwards their nurse took photos. They think laser could be effective but that I would get the most results from dermabrasion. I just don't know how I feel about dermabrasion since lasers have sort of taken its place. Their plastic surgeon would perform the dermabrasion and the nurse practitioner would perform the laser. Good reviews but not many before & afters of acne scar results, however they say they have helped patients with worse scars than mine.
1 hour ago, xander_33 said:I have another phenol cross procedure scheduled next month. During that visit I plan to discuss with Dr. Rullan what would be the best course of action for my scars.
Many of my scars have softened and I feel I just have bad overall texture. There are a few pits and atrophic areas that I want to try subcising once more. I want to ensure everything is leveled before deciding to go with laser resurfacing or dermabrasion.
I am in a tough spot right now. Whether or not to seek a strong ablative procedure or dermabrasion. Because of my ethnic skin doctors have cautioned me against CO2 lasers due to hyperpigmentation issues. I am getting exhausted at this point and might just take the risk.
I went to a plastic surgery clinic today and consulted with their aesthetician who evaluated my skin and afterwards their nurse took photos. They think laser could be effective but that I would get the most results from dermabrasion. I just don't know how I feel about dermabrasion since lasers have sort of taken its place. Their plastic surgeon would perform the dermabrasion and the nurse practitioner would perform the laser. Good reviews but not many before & afters of acne scar results, however they say they have helped patients with worse scars than mine.
I'm researching dermabrasion too. My issue with dermabrasion is the potential pigment issues. I want to get a test spot before doing my whole cheeks to see how my skin even responses to it. Yes, I've also wanted to do the Co2 laser since its the most effective against scarring but I was advised against it due to hyperpigmentation issues. If this is the laser, couldn't one month of a skin bleaching agent before procedure or pico laser after resolve the pigment issues? I've even asked about doing "one pass co2" with a high strength pass but never got anywhere.
I've received co2 ultrapulse though, it's most than likely not the same as co2 but maybe its close enough? https://europepmc.org/article/med/21061753
Erbium YAG laser is also an option since it is ablative but may need multiple treatments to get some improvement, but the improvement won't be drastic... unless you're a top 1% healer and respond exceptionally well to it. But again, unlikely.
43 minutes ago, Dontgiveupitsonlyscars said:I'm researching dermabrasion too. My issue with dermabrasion is the potential pigment issues. I want to get a test spot before doing my whole cheeks to see how my skin even responses to it. Yes, I've also wanted to do the Co2 laser since its the most effective against scarring but I was advised against it due to hyperpigmentation issues. If this is the laser, couldn't one month of a skin bleaching agent before procedure or pico laser after resolve the pigment issues? I've even asked about doing "one pass co2" with a high strength pass but never got anywhere.
I've received co2 ultrapulse though, it's most than likely not the same as co2 but maybe its close enough? https://europepmc.org/article/med/21061753
Erbium YAG laser is also an option since it is ablative but may need multiple treatments to get some improvement, but the improvement won't be drastic... unless you're a top 1% healer and respond exceptionally well to it. But again, unlikely.
Yeah I am ready to start progressing into laser treatments for my texture. You likely have more experience and knowledge in this area than I do. I am learning there are a variety of lasers tailored towards many purposes.
For scars like ours, non-ablative lasers are likely ineffective. Erbium lasers are ablative and are less risk adverse for our skin-types. CO2 are generally stronger than erbium laser, but I think the technique and settings dialed by the practitioner play a huge factor. The esthetician I spoke today mentioned pre-treating with hydroquinone to lessen the chances of my skin hyper-pigmenting after treatment. This is the first consult I had where the clinic felt more open to treating my skin with a CO2 laser which was surprising. Not sure if that is a good thing or bad thing though. For instance, the last 2 acne scar consults I had both recommended the same type of treatment fraxel-non ablative 1550 wavelength for the same reason, hyperpigmentation issues.
I am not sure who's right here, do I take the risk if I go with a more aggressive laser for better results or get very small or even no improvement with weaker lasers. I was thinking of trying to meet somewhere in the middle, which would be an erbium ablative laser. But you just said you received lackluster results?
7 minutes ago, xander_33 said:Yeah I am ready to start progressing into laser treatments for my texture. You likely have more experience and knowledge in this area than I do. I am learning there are a variety of lasers tailored towards many purposes.
For scars like ours, non-ablative lasers are likely ineffective. Erbium lasers are ablative and are less risk adverse for our skin-types. CO2 are generally stronger than erbium laser, but I think the technique and settings dialed by the practitioner play a huge factor. The esthetician I spoke today mentioned pre-treating with hydroquinone to lessen the chances of my skin hyper-pigmenting after treatment. This is the first consult I had where the clinic felt more open to treating my skin with a CO2 laser which was surprising. Not sure if that is a good thing or bad thing though. For instance, the last 2 acne scar consults I had both recommended the same type of treatment fraxel-non ablative 1550 wavelength for the same reason, hyperpigmentation issues.
I am not sure who's right here, do I take the risk if I go with a more aggressive laser for better results or get very small or even no improvement with weaker lasers.I was thinking of trying to meet somewhere in the middle, which would be an erbium ablative laser. But you just said you received lackluster results?
No, I wouldn't say erbium had lackluster results for me. But I also wouldn't say it fit my expectations. Maybe I'm hard on myself but for how many erbiums I have done, which is at least four, I don't think it was as effective as it's said to be or as I expected it to be. I have a love-hate relationship with lasers for older acne scarring. I like lasers for new scarring though, such as excisions. But also, excisions aren't unpredictable so, not the best idea to get multiple excisons on your face unless you have considered the possible risks.
I think I'm more sick of the cost of each procedure ($600-$950 each) and the downtime/after care in versus how very minimal the scars will appear to respond to the procedure. Of course, collagen remodeling occurs 3-6 months after injury but still, results are not as impressive, at least for me. Then again, you may respond differently. You may benefit from the improvement of some scarring and not others, which would help with your overall comfort level. I will concede that some particular scarring has decreased significantly for me while others ended up standing out more. I guess that is the trade-off.
Also, be aware that lasers have a fat-melting effect after a while. Does it occur in all patients? No. but it can occur. Yes, knowing which particular settings to use on certain scarring or patients helps. But I would personally argue lasers are not as skill dependent and that it does not usually require a doctor to perform it. I think it just requires experience and knowledge on how to use, which is why these laser companies love pitching to med spas.
2 hours ago, Dontgiveupitsonlyscars said:No, I wouldn't say erbium had lackluster results for me. But I also wouldn't say it fit my expectations. Maybe I'm hard on myself but for how many erbiums I have done, which is at least four, I don't think it was as effective as it's said to be or as I expected it to be. I have a love-hate relationship with lasers for older acne scarring. I like lasers for new scarring though, such as excisions. But also, excisions aren't unpredictable so, not the best idea to get multiple excisons on your face unless you have considered the possible risks.
I think I'm more sick of the cost of each procedure ($600-$950 each) and the downtime/after care in versus how very minimal the scars will appear to respond to the procedure. Of course, collagen remodeling occurs 3-6 months after injury but still, results are not as impressive, at least for me. Then again, you may respond differently. You may benefit from the improvement of some scarring and not others, which would help with your overall comfort level. I will concede that some particular scarring has decreased significantly for me while others ended up standing out more. I guess that is the trade-off.
Also, be aware that lasers have a fat-melting effect after a while. Does it occur in all patients? No. but it can occur. Yes, knowing which particular settings to use on certain scarring or patients helps. But I would personally argue lasers are not as skill dependent and that it does not usually require a doctor to perform it. I think it just requires experience and knowledge on how to use, which is why these laser companies love pitching to med spas.
I think that can be said about all treatments. It really is important for acne scar sufferers to come in with realistic expectations. We get excited and fantasize about having clear skin that we are left disappointed when the scar still exists afterwards. Considering the prices of these treatments and what is being advertised I do expect a reasonable level of satisfaction. Over the years I have just become more cynical towards this industry and how some doctors prey on people's insecurities. Manipulating angles, lighting, and pushing these package deals onto their patients that are ineffective for their scars. At the end of the day it's a business and they have a product to sell. I don't blame them, the machines are expensive and in order to pay them off, they have to charge exorbitant prices for their treatments. This is not to say there aren't doctors out there with good intentions. I don't want to get too philosophical but again and again I ask myself why things of this nature are not covered under insurance as it is more than just a cosmetic intervention. Acne scars affect us in ways deeper than the skin...
Anyways, this is why users here heavily advocate for manual methods like subcision, cross, and microneedling. They should be a patient's first approach partly because there is "less" of a marketing scheme that exists here.
The fat-loss effect from heating the dermis with lasers is what is making me lean towards dermabrasion. I feel if I lose any more volume in my face my existing scarring will look worse.
Right now my biggest gripe with my skin is the overall texture and one deep, boxcar scar on my right check (Filler and/or excision might be the only option for this scar) There are still pits around my temples that are bothersome. Some deep boxcars and icepicks. It all contributes to the baseline level of scarring from which I want to improve on. It's hard to say at what point will i be satisfied and comfortable enough to stop worrying about my skin.
QuoteThe fat-loss effect from heating the dermis with lasers is what is making me lean towards dermabrasion. I feel if I lose any more volume in my face my existing scarring will look worse.
I was under the impression lasers help promote collagen production and therefore fill volume instead of lose volume? I'm being pushed towards multiple subcisions and very strong lasers right now to try and produce as much collagen as possible to try and get some permanent improvement before using any fillers
On 9/14/2022 at 12:48 AM, giannis said:I was under the impression lasers help promote collagen production and therefore fill volume instead of lose volume? I'm being pushed towards multiple subcisions and very strong lasers right now to try and produce as much collagen as possible to try and get some permanent improvement before using any fillers
I think lasers are good for scars but not texture. Im the sense that it cause fat loss since it is done by energy if that energy travels down. It can go to fat cells and that would kill it. Same is not true with deep peel.
22 hours ago, getsmart121 said:Did you get phenol cross and erbium combo? Also take dr best collagen 1 and 2. And keep applying topical vitamin c. Phenol is basically damaging skin and we are hoping it will heal well
It was just phenol cross. I am aware he has a new technique though where he combines the two, erbium + cross, saying he has seen great success with it.
14 hours ago, getsmart121 said:Is this immediately after treatment. It just takes time
The above photos were taken approximately 3 months after the procedure. I have been applying hydroquinone these past couple of weeks leading up to my profractional which I believe is making my skin look worse than it normally is.